A hip labral tear occurs when a piece of cartilage that surrounds the hip joint tears. This causes pain and instability in the hip joint.
Certain people may be more likely to develop a hip labral tear, including those participating in high impact sports such as:
- hockey
- football
- soccer
People with hip impingement or arthritis are also at an increased risk.
A range of treatments can help hip labral tears. Depending on the severity of the injury, treatments may include:
- physical therapy
- exercises
- corticosteroid injections
- surgery
In this article, we examine hip labral tears and their symptoms. We also examine the causes and how doctors diagnose and treat the condition.
A labral tear is a tear in the cartilage that lines the hip socket.
The hip joint is a ball-and-socket joint, which means that the head of the thighbone or femur fits into a shallow socket in the pelvis called the acetabulum. The labrum is a cartilage ring that surrounds the socket’s edge and helps absorb shock and stabilize the joint.
Doctors classify labral tears as anterior, at the front of the body, or posterior, at the back. Most tears are anterior.
In a 2021 study of almost 2,000 participants who had surgery to repair a labral tear, more than 9 in 10 were anterior tears.
The most common symptom of a hip labral tear is hip or groin pain at the front of the body, which can radiate to the knee.
The pain usually develops gradually. It often occurs at night and feels like a constant, dull pain. However, certain activities can cause sharp pain, such as:
- walking
- pivoting
- prolonged sitting
- running
An individual may feel like the leg may give way or lock. There may also be clicking sounds when bending the limb.
Complications
A hip labral tear increases the likelihood of developing osteoarthritis in the joint. It can also lead to chronic hip pain and disability.
Causes of hip labral tears include:
- repetitive motions that lead to wear and tear
- traumatic injury, such as sporting injuries
- hip impingement, a condition where there is atypical contact between the ball and socket of the hip
- osteoarthritis, which causes cartilage degeneration and rough bone in the hip
A doctor uses a person’s symptoms, medical history, and a physical exam to diagnose a hip labral tear.
During an exam, they may use the following tests to help narrow down the source of hip pain:
- Anterior hip impingement test: This involves a 90-degree flexion of the hip and knee, with rotation of the hip. If a person has pain at the front, it implies an anterior tear.
- Posterior hip impingement test: A person lies down with hip and knee extended. If movement and rotation cause pain, it may suggest a posterior tear.
- FABER test: FABER stands for flexion, abduction, and external rotation. It involves placing one foot over the opposite knee in a figure-of–four position and applying slight pressure to the inner side of the knee.
- Resisted straight leg raise test: Experts also call this the Lasegue test — this maneuver assesses if there is irritation in the lumbosacral nerve root.
- Log-roll test: This involves a person lying on their back while the doctor passively moves the leg through the maximal available range of rotation.
A doctor may order imaging tests, including X-rays and MRIs.
If a labral tear causes discomfort, a doctor may recommend the following:
- resting the leg
- avoiding painful activities
- using crutches or a cane
- taking nonsteroidal anti-inflammatory drugs (NSAIDs)
- having intra-articular injections of corticosteroids
- physical therapy
If treatment does not help, a doctor may recommend surgery to repair the tear. Surgeons can perform these surgical procedures arthroscopically, which is a type of keyhole surgery, or with open surgery.
After surgery, a person will need several weeks of rest and physical therapy to regain strength and flexibility in the hip.
Exercises aim to increase the range of motion and strengthen the muscles around the hip, stabilizing the joint.
A physical therapist can develop a personalized exercise program. They may tell a person to complete the following steps:
- Sidestepping with resistance: Using a resistance band on the legs, take side steps while maintaining tension on the band.
- Glute bridge: Lie flat on the back, with the feet flat on the ground and knees bent. Drive through the heels to lift the hips and glutes off the ground.
- Side planks: Start by lying on the side with legs stacked on each other and the forearm on the floor. Then, lift the hip off the floor with weight on the forearm.
- Single leg deadlift: With the legs hip-length apart, shift weight to one leg and hinge forward at the hips while keeping the back flat. Lean forward until the body is parallel to the ground, then return to standing.
- Bridge: Lie on the back with knees bent and feet flat on the floor. Drive through the heels to lift the hips and glutes off the floor while squeezing stomach muscles.
- Dead bug: Lie on the back while holding arms and legs in the air. While keeping the lower back pressed to the floor, alternate moving the opposite arm and leg toward the floor and then back to the starting position.
A hip labral tear is a tear in the cartilage that lines the hip socket. The most common symptom is hip or groin pain.
A doctor may recommend NSAIDs, physical therapy, or surgery to treat a hip labral tear. A person with hip pain should speak with their doctor for an accurate diagnosis and treatment to avoid future complications.